Chest Physiotherapy (CPT)
What is it? | What is the treatment? | Why is it recommended? | How is it done? | Who performs it? | What are the risks? | Does it work?
What is chest physiotherapy?
Chest physiotherapy (CPT) is a treatment often used with children who have had heart surgery and who may have partial collapse of their lung tissue or lung secretions which they are unable to clear by themselves.
Chest physiotherapy is also known as "chest physical therapy," or "postural drainage and percussion."
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What is the treatment?
Chest physiotherapy is designed to use gravity to aid in draining secretion from various areas of the lungs. The patient lays in special ways to drain secretions from the smaller airways into their larger airways.
While the patient is lying down, rhythmic clapping (percussion) is applied with moderate to vigorous strength. The percussion is applied to the chest wall.
This helps loosen secretions from the respiratory tract, and forces the mucus from the smaller airways into the larger airways. The secretions can either be coughed up by the patient, or suctioned out.
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Why chest physiotherapy would be recommended
Chest physiotherapy is used for different reasons. When patients cannot bring up secretions, chest physiotherapy may be helpful.
Chest physiotherapy is also used for patients with pneumonia or patients with cystic fibrosis. Patients may have trouble taking deep breaths after surgery. When this happens, the lungs may not fully inflate. Chest physiotherapy has been helpful in treating this condition.
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How is chest physiotherapy done? It is painful or uncomfortable?
Chest physiotherapy is done by lying the patient in various positions. These positions include: sitting up, lying on their back, lying on their side, and lying with their head down.
While in these positions, the therapist's hand is cupped. The hand repeatedly hits the chest wall. If the child is small, the therapist may use a mask instead of their hand. This treatment itself will not hurt the patient.
Some patients may be very sore because of surgery. When this happens, a machine that gently vibrates can be applied to the chest.
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Who orders or performs chest physiotherapy, and where is the treatment performed? When or how often is the treatment done?
The doctor taking care of the patient will order chest physiotherapy. The respiratory therapist or the nurse will perform the treatment.
Chest physiotherapy is done at the patient's bed, which is made to be positioned for this type of treatment.
The treatment may be performed as often as every two hours. Most of the time, the treatment is done four times every day.
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What are the risks or possible complications of chest physiotherapy?
Chest physiotherapy should be not used on every patient. Patients with brittle bones or broken rib bones should not receive chest physiotherapy. This may cause the bone problem to become worse.
Chest physiotherapy should not be performed when a patient is unstable. This may lead to the patient condition becoming more serious.
Chest physiotherapy should not be used if the patient has increased pressure in their skull. If the patient is coughing up blood, has a lot of pain, has just eaten, or is vomiting, chest physiotherapy should be postponed until these conditions are no longer present.
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Does chest physiotherapy work?
Although chest physiotherapy has only been shown to work in patients with cystic fibrosis, it is felt to be useful in patients in the intensive care unit who are not very mobile after heart surgery or for other reasons when they are unable to keep all areas of the lung open.
Chest physiotherapy has been successful in some patients in preventing the need for more aggressive treatment (i.e., mechanical ventilation).
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Revised 9/06
